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2017 Kansas 21 st CCLC RFA 1 Kansas 21st Century Community Learning Centers Program 2017 Competition Request for Applications (RFA) Early Childhood, Special Education & Title Services Kansas State Department of Education Grant No. 2017 THIS RFA IS FOR NEW APPLICANTS ONLY Send one signed original and four paper copies and an electronic copy to: Christine Macy Kansas State Department of Education 900 SW Jackson Street, Suite 620 Topeka, KS 66612-1182 ATTN: 2017 21 st CCLC GRANT cmacy@ksde.org Applications must be received by 3:00 p.m. Thursday, March 16, 2017 An Equal Employment/Educational Opportunity Agency The Kansas State Department of Education does not discriminate on the basis of race, color, national origin, sex, disability, or age in its programs and activities and provides equal access to the Boy Scouts and other designated youth groups. The following person has been designated to handle inquiries regarding the non-discrimination policies: KSDE General Counsel, Office of General Counsel, KSDE, Landon State Office Building, 900 SW Jackson, Suite 102, Topeka, KS 66612, (785) 296-3204.

2017 Kansas 21 st CCLC RFA 2 Dear Applicant: Thank you for your interest in the 2017 Kansas 21 st Century Community Learning Centers Grant (21 st CCLC), which awards grants to applicants that will provide expanded learning and enrichment opportunities for children outside of the regular school hours. The Kansas State Department of Education (KSDE) encourages projects to be submitted jointly by school districts and community- and/or faithbased organizations. KSDE will fund only those projects that provide significant expanded learning opportunities for children and youth that demonstrate how they will help students meet or exceed state and local standards in core academic subjects and meet the Absolute Priority, as defined on page 8 of the Request for Application (RFA). There are two application types: 1) New Application and 2) Re-Application. A NEW Application should be completed if: The applicant is applying for a SITE that has never received 21 st CCLC funds; or The applicant is applying for a SITE that has not received 21 st CCLC funds within the past five years. (Please refer to the Re-Applicant RFA if the proposed program was awarded Kansas 21 st CCLC funds within the past five years.) The deadline for this competition is 3:00 p.m. Thursday, March 16, 2017. Applications must be received at KSDE in Topeka by that date and time in order to be eligible for review. KSDE requires applicants to submit one signed original and four paper copies of an application. KSDE is also requiring applicants to submit an electronic copy to Christine Macy at cmacy@ksde.org. Applications will be reviewed by a panel of experts using the selection criteria in this RFA. It is anticipated that awards will be announced in mid-june for use by grantees July 1, 2017. This application package contains the forms and instructions necessary to apply for the 2017 Kansas 21 st CCLC Grant. Please review the enclosed materials and carefully follow the instructions for completing the grant application. Before submitting the application, review the provided checklist to ensure all required components are included. An Intent to Apply form can be found on page 4. Please submit this form to tlutze@ksde.org no later than February 23, 2017. This will help ensure that KSDE secures a sufficient number of external reviewers. Due to the popularity of this program, KSDE expects this grant competition to be extremely competitive. To ensure that applications are of the highest possible quality, KSDE will conduct four Applicant Workshops. All workshops are scheduled from 9 a.m. Noon. Topeka January 23rd Topeka Shawnee County Library (Marvin Auditoriums 101 A and B) o Register at https://www.ksdetasn.org/events/adpgew Wichita January 24 th Sedgwick County Extension Education Center (Meadowlark) o Register at https://www.ksdetasn.org/events/q0jl-a Dodge City January 25 th Rose Room, Ford County Building (Dodge City) o Register at https://www.ksdetasn.org/events/bnip1q Hays January 26 th Fort Hays University (Custer Hall) o Register at https://www.ksdetasn.org/events/cpc-sq Participants MUST register by January 19 th to participate in the workshops.

2017 Kansas 21 st CCLC RFA 3 *An Applicant Webinar will be scheduled for those not able to attend a workshop. KSDE encourages applicants to consult extensively within identified communities to ensure that parents, community organizations, businesses, arts and cultural organizations and other child and youth development agencies can work in meaningful collaboration with applicants in order to become Kansas 21st Century Community Learning Centers. Applicants should contact Christine Macy at: cmacy@ksde.org/(785)296-3287 or visit the KSDE website at http://www.ksde.org/default.aspx?tabid=740 with any questions. Colleen Riley, Director Early Childhood, Special Education and Title Services Kansas State Department of Education

2017 Kansas 21 st CCLC RFA 4 Intent to Apply for a Grant Under the 2017 Kansas 21st Century Community Learning Center Competition (Please submit this form by February 23 rd ) Any district/organization expecting to apply for a grant in this competition, please email this form to Tammy Lutze at tlutze@ksde.org. Submitting this form does not obligate the potential applicant to apply, but it does help KSDE prepare for the review session. Contact Name: Email: Please indicate the application status of the USD/Organization being represented. The potential applicant plans to submit a: (Please provide the number of proposed applications.) New Application # Re-Application # Name of the group represented: City: USD Name/Number:

2017 Kansas 21 st CCLC RFA 5 Kansas 21st CENTURY COMMUNITY LEARNING CENTERS PROGRAM 2017 APPLICATION PACKET TABLE OF CONTENTS Intent to Apply Form 4 What is the 21st Century Community Learning Centers Program? 6 What is the definition of a 21st Century Community Learning Center? 6 What organizations are eligible to apply for Kansas 21st CCLC funds? 6 Must an applicant collaborate with other organizations? 7 What is the definition of a community-based organization? 7 What will be the time period and size of grants? 7 Is there a financial match requirement? 7 What priorities apply to this competition? 8 What if the application is submitted jointly with a co-applicant? 9 What are the procedures for reviewing applications and awarding funds? 9 How does an applicant prepare an application for a 21st CCLC grant? 9 21st Century Community Learning Center Application 10 How should an application be submitted? 18 Application Checklist and Required Forms 19 Program Summary 20 General Statement of Assurances 23 Private School Consultation Form 25 Budget Summary Years One through Five 26 Detailed Budget Summary Forms by year 27

2017 Kansas 21 st CCLC RFA 6 INFORMATION AND GUIDELINES 1. What is the 21st Century Community Learning Centers (21 st CCLC) Program? The 21st CCLC Program was amended by Congress as Title IV, Part B of the Elementary and Secondary Education Act (ESEA), the No Child Left Behind Act (NCLB) of 2001. The purpose of this program is to create community learning centers that provide academic enrichment opportunities for children, particularly in grades Pre-K-12, who attend high poverty and low-performing schools, to meet state and local standards in core academic subjects, to offer students a broad array of enrichment activities that can complement their regular academic programs and to offer literacy and other educational services to the families of participating children. NCLB recognizes that improved student achievement occurs when communities implement programs and strategies scientifically proven to be effective, and the 21st CCLC Program is an essential part of this initiative. In 2002, the federal 21st CCLC funds shifted to states, for distribution as competitive block grants. The title of this competition is the 2017 Kansas 21st Century Community Learning Centers Grant. 2. What is the definition of a 21st Century Community Learning Center? The 21 st CCLC program is authorized under Title IV, Part B of the ESEA, as amended by the NCLB Act of 2001. Its purpose is to create or expand community learning centers that: 1. Provide opportunities for academic enrichment, including providing tutorial services to help students, particularly students who attend low-performing schools, to meet State and local student academic achievement standards in core academic subjects such as reading and mathematics; 2. Offer students a broad array of additional services, programs and activities, such as child and youth development activities, drug and violence prevention, counseling, art, music, recreation, technology education and character education, that are designed to reinforce and complement the regular academic program of participating students; and 3. Offer families of students served by community learning centers opportunities for literacy and related educational development. Multiple program options may be used by all recipients of funding under the 21st CCLC grant including before school, after school, weekends, holidays or summer recess. *Kansas 21 st CCLC Grants will not fund summer only programs. 3. What organizations are eligible to apply for NEW Kansas 21st Century Community Learning Centers funds? Any public or private organization is eligible to apply for a NEW Kansas 21st CCLC grant if: The applicant is applying for a SITE that has never received 21 st CCLC funds; or The applicant is applying for a SITE that has not received 21 st CCLC funds within the past five years. (Please refer to the Re-Applicant RFA if the proposed program was awarded Kansas 21 st CCLC funds within the past five years.)

2017 Kansas 21 st CCLC RFA 7 Examples of agencies and organizations now eligible under the 2017 Kansas 21st CCLC Grant include, but are not limited to: school districts, non-public schools, non-profit agencies, city or county government agencies, faith-based organizations, institutions of higher education and for-profit corporations. 4. Must an applicant collaborate with other organizations? No. Although all applicants are strongly encouraged to collaborate to the extent possible, they are not required to do so. Applicants may collaborate with public and non-profit agencies and organizations, businesses, educational entities (such as public schools, vocational and adult education programs, school-to-work programs, community colleges or universities), recreational, cultural and other community service entities. KSDE encourages all interested parties to submit applications jointly between school districts, community-based organizations and/or faith-based organizations. By statute, applicants are required to describe in their applications the collaborative efforts to be undertaken by community-based organizations, related public agencies, businesses or other appropriate organizations. 5. What is the definition of a community-based organization? As defined in section 9101(6) of NCLB, the term community-based organization means a public or private nonprofit organization of demonstrated effectiveness that (A) is representative of a community or significant segments of a community; and (B) provides educational or related services to individuals in the community. 6. What will be the time period and size of grants? Time period: A 2017 Kansas 21st CCLC Grant cannot exceed five years. Continuation from one year to the next, within the five years, is contingent upon program performance and appropriations by Congress. Size of grants: By statute, grants may not be awarded for less than $50,000 per year. The maximum 2017 award is $100,000 for grant years 1, 2 and 3. Diminution of funds: Applicants need to be aware that Kansas 21st CCLC funds will diminish during the fourth and fifth years of the five-year grant. Funds will be awarded in full during the first three years of the grant. During the fourth year, Kansas 21st CCLC funds will pay 80 percent of the average of the first three years of the award. During the fifth and final year of the grant, Kansas 21 st CCLC funds will pay 70 percent of the average of the first three years of the award. The budget, included in the application, must reflect this diminution of grant funds. TRANSPORTATION ALLOWANCE: Applicants proposing to serve students in districts that are REAP (Rural Education Achievement Program) eligible may request up to $25,000 in addition to the maximum grant award for transportation costs. (The additional allowance may only be used for daily transportation to and from programs.) DETAILS CAN BE FOUND ON PAGE 16. 7. Is there a financial match requirement? No.

2017 Kansas 21 st CCLC RFA 8 8. What priorities apply to this competition? There are three priorities for this grant. All applicants must meet the Absolute Priority. Applicants have the option to earn additional points if either or both of the Competitive Priorities are met. Absolute Priority: Targeting services to low-income schools. Kansas is required to make awards only to applicants that will primarily serve students and families who have students that attend schools where at least 40% of the students qualify to receive free or reduced-cost meals. Free and reduced percentages can be located on the Data Central page on the Kansas State Department of Education website (www.ksde.org) or directly at the following URL: http://datacentral.ksde.org/report_gen.aspx. Primarily means that at least 51% of students to be served in the proposed program must attend eligible schools. Applications that do not meet the Absolute Priority will NOT be considered for funding. Competitive Priority I: (5 pts.) Applicants that will serve students attending schools that have been identified for Comprehensive Support. http://www.ksde.org/portals/0/ecsets/esea/csi_schools.pdf AND that are submitted jointly with community-based and/or faith-based organizations or public or private organizations could potentially receive five (5) priority points. If an applicant demonstrates inability to partner with a community-based organization in reasonable geographic proximity and of sufficient quality to meet the requirements of this part, it is still possible to be awarded this priority. In determining whether an application has been submitted jointly, KSDE will look for the following evidence in the application: The applicant and at least one other organization/school district collaborated in the planning and design of the program; Each Partner has a substantial role to play in the delivery of services, share grant resources to carry out those roles; and Have significant ongoing involvement in the management and oversight of the program. Applications must have a co-applicant to meet Competitive Priority I and receive five (5) priority points. Competitive Priority II for Summer Programming: (5 points) Applicants that incorporate a summer component in addition to other out-of-school programming could potentially receive five (5) priority points. All details for summer programming should be included in the following sections of this application. Program Narrative Need for Program Quality of Program Design Quality of Management Plan Adequacy of Resources Budget Summary and Budget Narrative *A summer component must include both academic and enrichment elements.

2017 Kansas 21 st CCLC RFA 9 9. What if the application is submitted jointly with a co-applicant? KSDE will consider which organization(s) wrote the application, which organization will be the fiscal agent, whether there is a history of these organizations working together and whether there is evidence in the application of integration of the after school program activities with the regular school day. Evidence of this should be reflected in the Quality of Program Design and Quality of Management Plan sections of the application. 10. What are the procedures for reviewing applications and awarding funds? Following a rubric, impartial reviewers assign a score to each component of the Program Narrative as well as the Budget Summary and Budget Narrative. Any competitive points are added to the total score. (Applicants must earn at least 75% of total points available in the Quality of Program Design to be eligible to receive priority points.) Reviewers recommend which grants should be funded. KSDE staff negotiates all final budget allocations. Recommendations are submitted to the Kansas State Board of Education for approval. 11. How does an applicant prepare an application for a 21st Century Community Learning Centers Grant? Carefully read the entire RFA. Submit an Intent to Apply form by February 23 rd. A completed application must contain the following sections, in the order provided below. Copies of all forms discussed in the following section are provided in the Required Forms part of this RFA. Cover Sheet Application Checklist Program Summary General Statement of Assurances Private School Consultation Form Program Narrative Budget Summary and Budget Narrative Appendices * KSDE reserves the right to disqualify incomplete applications. 21st Century Community Learning Centers Grant Competition Appeals Process Any applicant may request reviewer scores and feedback from the Kansas State Department of Education (KSDE). If an applicant is dissatisfied with the results, an inquiry of the review process may be requested within 14 days of official notification of application funding status. The inquiry must be directed to the Kansas 21st Century Community Learning Centers (21st CCLC) State Coordinator and must state the reason for the request. KSDE will conduct an internal review and share the findings with the applicant within 30 days of the request. All funding decisions are final.

2017 Kansas 21 st CCLC RFA 10 2017 KANSAS 21 ST CENTURY COMMUNITY LEARNING CENTERS APPLICATION KSDE will use the six criteria located in the Program Narrative, as well as the Budget Summary and Budget Narrative, to evaluate applications for funding. The points for each criterion are indicated in parentheses. Each selection criterion is presented and explained below. The reviewers of each application will use these criteria to guide their scoring, so it is in the applicant s best interest to address them (in order) in the application. Furthermore, the 2017 Kansas 21st CCLC Grant competition requires local grantees to implement programs that meet the following four Principles of Effectiveness: 1. An assessment of objective data regarding need for out of school programs (including before school, after school, summer or any time school is not in session); 2. An established set of performance measures aimed at ensuring the availability of highquality academic enrichment opportunities; 3. Scientifically-based research that provides evidence that the program or activity will help students meet state and local student academic achievement standards; and 4. Family engagement components that are linked to learning and embedded into all programs through systemic goals. Application Order Cover Sheet including the program title, name of applicant(s), school district to be served and date. Application Checklist Program Summary (Required Form 2017:1) The applicant must provide the contact and descriptive information requested. General Statement of Assurances (Required Form 2017:2) The Chief Executive Officer of each applicant organization must sign the assurances. The fiscal agent must also be identified. Private School Consultation Form (Required Form 2017:3) Program Narrative: - Applicants must limit the program narrative to no more than 20 double-spaced pages. - Each page should only be printed on the front side of the paper (no double-sided printing). - Font must be 11-point, standard type. - Charts do not need to be double-spaced but should remain in 11-point. - Margins should be one inch on all sides of each page. - Please include page numbers and applicant(s) name in upper right corner of every page. In preparing the Program Narrative, applicants should pay close attention to the selection criteria that will be used to evaluate applications and ensure that each is addressed. 1. Need for Program 2. Quality of Program Design 3. Quality of Management Plan 4. Sustainability Plan 5. Quality of Program Evaluation 6. Adequacy of Resources

2017 Kansas 21 st CCLC RFA 11 Budget Summary and Budget Narrative (Required Form 2017:4) The Budget Narrative may be single-spaced. Appendices (A, B, C, D, E) o A A list of Advisory Group members or partners and letters of commitment o B Evidence of Previous Success o C Description of Previous or Current Out-of-School Time Program o D Evidence of Child Care Licensure o E Equitable Access and Participation Program Narrative Selection Criteria Details (20-page limitation) 1) Need for Program (10 points for this entire section) This section describes the extent of the NEEDS of the children and youth for the proposed services. In doing this, the applicant should (using charts if applicable) explain why the Kansas 21 st CCLC Program will serve the needs of the children and youth described. (A) (7pts.) Cite the factors that place the students at risk of educational failure. For example, (but not limited to): 1. Poverty rates in the communities to be served, 2. Percentage or rapid growth of Limited English Proficient students and adults, 3. Percentage of Title I students, 4. High school dropout rate(s), 5. Needs of working families, 6. Literacy rates, 7. Juvenile crime rates and/or 8. Educational levels in the community and other factors. Use specific and relevant data regarding the students to be served by the program and the needs of the community. Always cite sources of data and compare local data to county and/or state figures when possible. This section should also include a baseline data chart that gives information (with date and source) for each site on the following items to be measured by the Performance Goals and Indicators (page 13). Percentage of students suspended Percentage of students who engage in violent acts (B) (3 pts.) One of the principles of effectiveness states that the program must include an assessment of objective data regarding need for out of school programs and activities in the schools and communities. To do so, the application must describe any local needs survey(s) that proves need or illustrates community support for overcoming need. The applicant must clearly state the specific needs of the students and families to be served that will be addressed by the proposed program design that will follow this section. 21 st CCLC funds cannot take the place of secured funding. If an applicant currently operates an out-ofschool time program, that should be noted in this section. A description of how the 21 st CCLC grant will expand the program or reasoning as to why 21 st CCLC funds are necessary is required. This information should be included in Appendix C (limited to one page). 2) Quality of Program Design (45 points for this entire section) The Program Design section of the narrative is the core of the application. The reviewers should be able to picture what will happen every day in the program. It must include sufficient detail to convince the

2017 Kansas 21 st CCLC RFA 12 reviewers that the plan is realistic and achievable, and it must provide an overall vision of the proposed out of school program. In doing so, the Program Design section must address A, B, C, D and E below. (A) (25 pts.) Describe the vision for the program. This section must include the following: 1. Who and how many students will be served (and how the estimates were figured); 2. How students will be recruited for the program; 3. What literacy and other educational services will be offered to families of participating students; 4. How the organization will disseminate information about the center (including its location) to the community in a manner that is understandable and accessible; 5. How and when private schools were consulted while developing the program design (see attached required form); 6. What activities the program will sponsor during which times of the day, week, year before school, after school, weekends, summer, school holiday and in-service (summer only programs do not qualify for funding); 7. What a typical week looks like (provide chart or table with details); 8. Staff/student ratio; 9. Fees, if any, that will be charged for the program. (Note: Fees cannot hinder any student from attending the program.) 10. Non-LEA applicants must provide evidence of collaboration with the school district in which the program will take place in order to have appropriate access to required reporting data (i.e. grades, assessments, etc.). (B) (7 pts.) Describe how the proposed program will address or remedy the risk factors for the target population. The services to be provided should be closely tied to the needs identified in the Needs Section. Explain how the program will tailor the activities to address the specific needs of participants and to achieve the desired outcomes. For example, explain how the program will provide services that are not currently available during the regular school day; how program staff will vary their approaches to help meet a child s individual needs; and/or how staff will collaborate with regular school day teachers to address students needs. Explain whether the program will be providing tutoring vs. homework help. (C) (5 pts.) Describe how the proposed program will assist students in achieving the Kansas 21st CCLC Performance Goals and Indicators. One of the principles of effectiveness is that programs or activities must be based on an established set of performance measures. The Kansas 21st CCLC Program has set Performance Goals and Indicators to be measured in the statewide program (see page 13). There should be a direct correlation between the program and the state content standards and student academic achievement standards. Specific goals and indicators should be addressed. The Kansas Goals and Indicators chart as seen in this application should not be cut and pasted into the application without being addressed and connected to program content. (D) (5 pts.) Describe how family engagement will be systemically embedded throughout the program. Family engagement should be collaborative, interactive and specifically linked to learning. This component should support the 21 st CCLC Performance Goals and Indicators 3.A, 3.B and 3.C. The program environment should reflect respect for families and community connections for families. In addition, program policies and procedures should be responsive to the needs of children, youth and families. (E) (3 pts.) Describe the extent to which the proposed program will establish partnerships with other appropriate agencies and organizations providing services to the target population. In Appendix A, please include letters of commitment or memoranda of understanding that clearly indicate the role and capacity of each partnering organization discussed in the application. Applicants are advised that the quality of letters of commitment, with a clear demonstration of buy-in from senior administrators of the partnering organization, is more important than the number of letters.

2017 Kansas 21 st CCLC RFA 13 Kansas 21st CCLC Performance Goals and Indicators The legislation requires states to develop performance indicators and performance measures that can be used to evaluate programs and activities. Grantees must periodically evaluate their programs to assess progress toward achieving the goal of providing high-quality opportunities for academic enrichment. The 2017 Kansas 21st CCLC Program has set the following Performance Goals and Indicators for this competition. Applicants must include them in the program (in addition to any others the applicant wishes to include), and must address (in Program Design section) and measure them (Evaluation Plan sections of narrative). This chart refers to Section C in Program Design Performance Goals and Indicators: Kansas 21st CCLC Program ESEA Goals, Indicators, State Performance Targets Performance Goal 1: All students will reach high standards, at a minimum attaining proficiency or better in reading/language arts and mathematics. 1. A Performance indicator: In each year of the grant program, the percentage of students enrolled in the program who receive grade cards at the end of every term, and who complete the Kansas State Assessments during the academic year. 1. A.1 Performance target: 80 percent of the program-enrolled Pre-K 12 participants will maintain high academic achievement and/or demonstrate continuous improvement in mathematics and reading, based upon grades and results of Kansas State Assessments. 1. B Performance indicator: The percentage of students who are offered tutoring support in the 21st CCLC program. 1. B.1 Performance target: 100 percent of the program-enrolled Pre-K 12 participants will be offered tutoring support. 1. C Performance indicator: The percentage of Pre-K 12 participants whose day teachers report increased rates of homework completion among their students who attend the program and who are assigned homework. 1. C.1 Performance target: Day teachers of 60 percent of Pre-K 12 participants who are assigned homework will report increased rates of homework completion among their students who attend the program. Performance Goal 2: All students will graduate from high school. 2. A Performance indicator: In each year of the grant program, the percentage of students enrolled in the program who are suspended (in-school or out-of-school). 2. A.1 Performance target: 90 percent of participants will not be suspended (in-school or out-of-school) while in the program. 2. B Performance indicator: In each year of the grant program, the percentage of students enrolled in the program who participate in activities integrating real-life problem solving, arts education, career exploration and service learning. 2. B.1 Performance target: 90 percent of Pre-K 12 students enrolled in the program will participate in activities integrating educational activities with: real-life problem solving, arts education, career exploration, recreation, cultural opportunities and activities and service learning. 2. C Performance indicator: In each year of the grant program, the percentage of students enrolled in the program that are found to have engaged in violent acts at school. 2. C.1 Performance target: 80 percent of program-enrolled Pre-K 12 participants will not be found to have engaged in violent acts at school. Performance Goal 3: Family engagement will be embedded in the entirety of the program. 3.A Performance Indicator: In each year of the program, the percentage of families/guardians of students enrolled in the program who are offered a variety of services and educational resources. 3.A.1 Performance Target: A variety of services and educational resources will be offered to the families/guardians of 100 percent of all program participants. 3.B Performance Indicator: Family communication associated with improved academic achievement and children and youth outcomes. 3.B.1 Performance Target: 80 percent of families surveyed will indicate satisfaction with family communication. 3.C Performance Indicator: In each year of the program, three effective family engagement practices. 3.C.1 Performance Target: 80 percent of families will be engaged in the provided opportunities.

2017 Kansas 21 st CCLC RFA 14 3) Quality of the Management Plan (10 points for the entire section) This section describes the plan for effectively staffing and managing the proposed program described in the Program Design section. Here the applicant will describe plans for who will create the academic and enrichment programs to ensure the standards are met; who will manage the program; who will teach; and who is the fiscal agent. The applicant will describe how all will work together for the success of the program. (A) (5 pts.) Describe the adequacy of the management plan to achieve the objectives of the proposed program on time and within budget, including clearly defined responsibilities, timelines and milestones for accomplishing program tasks. Include an organizational chart. In this section, the applicant should clearly delineate the roles to be played by each of the partners, describing who will do what, when, where, to what ends and with what anticipated results. Which applicant will be the fiscal agent? Describe applicant s and fiscal agent s experience in managing grant funds, diverse staff and substantial budgets. Such experience may be fully described in Evidence of Previous Success, in Appendix B, instead of in this section. Clarify its location here. (B) (3 pts.) This section should explain how the applicant(s) will ensure the staff who will be working with students are qualified to do so, through proper certification or licensure or experience/endorsements for subjects/ages taught. Include job descriptions (in this section NOT in the Appendix) for key staff. How will the applicant(s) use qualified seniors and youth to serve as volunteers, if the applicant plans to do so. Applicants should give specific details to explain that program leaders have sufficient time to accomplish tasks (including a sustainability plan). Explain how the program will provide ongoing staff development and training and describe the role and responsibility of all key staff. *Staff development/training requirements Two staff must attend one national conference and one state conference approved by KSDE each grant year. In addition, new program directors will be required to attend an orientation meeting in July 2017 as well as the program directors meeting in the fall of each grant year. (C) (2 pts.) This section should explain how the applicant will ensure a diversity of perspectives in the operation of the proposed program, including those of parents, teachers, business community, a variety of disciplinary and professional fields, recipients or beneficiaries of services or others, as appropriate. An Advisory Group must be in place or established to oversee the activities of the proposed program. Will the group include all these members? Does the group already exist? What will be the role of such an Advisory Group? 4) Quality of Program Evaluation. (10 points for the entire section) In this section, applicants will explain how they will meet the requirement to evaluate the effectiveness of the program. The applicant may want to refer to the evaluation template on the KSDE website when completing this section. http://www.ksde.org/default.aspx?tabid=740 (A) This section should identify the external evaluator (individual s name) that has agreed to serve as the evaluator for the program and describe his/her qualifications. What evaluation experience has this person had? How many years? (B) Describe how the following items will be established and measured: Clear benchmarks to monitor progress toward specific objectives, All of the Kansas 21st CCLC Performance Goals and Indicators and The program impact on student learning and behavior. (C) Describe the evaluation design, indicating: What types of data will be collected; When various types of data will be collected; When site visits will be conducted;

2017 Kansas 21 st CCLC RFA 15 What methods will be used; What instruments will be developed and when (such as student and parent surveys); How the data will be analyzed; When reports of results and outcomes will become available; and How information will be used by the program to monitor progress and to provide accountability information to stakeholders about success at the program site(s). ***The cost of an evaluator cannot exceed 5% of the total direct cost of the program per year. 5) Sustainability Plan. (5 points for the entire section) KSDE requires that applicants address the issue of sustainability after these grant funds end. The applicant should explain the role of the advisory group in the securing of resources to support the continuation of the program. This plan should include fees (if they are being collected), partnerships, operating funds, etc. 6) Adequacy of Resources. (10 points for the entire section) In this section, applicants are to explain how the resources available, from all sources, are adequate to accomplish the program as proposed in the previous sections. Applicant will need to complete the Budget Summary and Budget Narrative Form 2017:5 for each grant year. (A) Referring to the child and youth needs listed in the Needs Section, describe available resources (including facilities, equipment, supplies and other resources) for the out-of-school time program from all appropriate partner agencies and from the applicant(s). Describe federal, state and local programs that will be combined or coordinated with the proposed program for the most effective use of public resources. It is important to demonstrate how the applicant will leverage existing resources, such as computer labs, libraries and classrooms to carry out program activities. Also describe the resources that partners are contributing, such as the use of community recreational areas, staff, supplies, etc. Refer in this section to applicant(s) experience or promise of success in providing educational and related activities that will complement and enhance the academic performance, achievement and positive child and youth development of students. This section may be amplified in Appendix B: Evidence of Previous Success. (B) Explain the extent to which the funds requested are reasonable in relation to the number of persons to be served on an average daily basis and to the anticipated results and benefits. The applicant is advised that costs should be allocated and will be judged against the scope of the project and its anticipated benefits. Explain the ways that resources and personnel have been carefully allocated for the tasks and activities described in the application, including safe transportation to and from the sites if transportation is needed. THIS CONCLUDES THE UP TO 20 PAGES OF NARRATIVE

2017 Kansas 21 st CCLC RFA 16 Budget Summary and Budget Narrative. (10 points for entire section). Please provide a complete budget summary and a separate, brief (one page) budget narrative for each year of the program that explains: The basis for estimating the costs of professional personnel salaries, benefits, staff travel; Materials and supplies, consultants and subcontracts, indirect costs and any projected expenditures; How the major cost items relate to the proposed activities; Budget for supplies cannot exceed the following: Year 1 25% / Year 2 15% / Years 3-5 10% of the grant total per year; A minimum of $4,000 must be allocated for travel expenses (expected to be reimbursed according to state guidelines) for TWO staff members to attend one national and one state conference per year; The cost of evaluation (cannot exceed 5% of the grant total direct cost for each year); A detailed description, as applicable, explaining in-kind support or funding provided by other funds or partners in the program (including fees collected); Grant funds cannot be used to purchase facilities or support new construction; In Year 4, the total grant award will be reduced to 80% of the average of the first three years of grant funds; In Year 5, the total grant award will be reduced to 70% of the average of the first three years of grant funds; Indirect costs should be calculated based on the negotiated rate but may not exceed 8% of total direct costs; Budgets will be reviewed on an annual basis and may be revised to reflect program needs. **KSDE reserves the right to limit expenses that are deemed not reasonable or allowable. ***TRANSPORTATION ALLOWANCE*** Applicants proposing to serve students in districts that are REAP (Rural Education Achievement Program) eligible may request up to $25,000 in addition to the maximum grant award for transportation costs. Applicants should contact the district in which the proposed grant will take place to determine eligibility. (The additional allowance may only be used for daily transportation to and from programs.) Clarification of the following are required: Number of students to be transported; Number of miles to be traveled daily; Breakdown of personnel ($ per hour x hours per day x days in program); and Explanation of transportation costs (maintenance/fuel, etc.). Appendices. Each application should be accompanied by Appendices, limited to the following: (If any additional information is included, the readers will not be allowed to view it.) Appendix A - A list of Advisory Group members or partners and letters of commitment. List all Advisory Group members or partners, contact persons, addresses and telephone numbers. Letters of commitment should be included in this section of the appendix to clearly document the role and contribution of each member. A partner provides resources and/or services. Appendix B - Evidence of Previous Success. Include a brief summary of any local needs surveys, grants awarded, or evaluation studies, reports, or research that may document the effectiveness or success of the applicant, the Advisory Group or the activities/services proposed in the narrative section of the application. If an applicant has never formed an advisory group or had any type of program outside of the regular school day, they need to state the lack of previous programming.

2017 Kansas 21 st CCLC RFA 17 Appendix C Description of Previous or Out-of-School Time Program (limited to one page). Provide a description of the program currently taking place and how 21 st CCLC funds will expand the program, or reasoning as to why 21 st CCLC funds are necessary. Appendix D Evidence of Child Care Licensure. Provide a copy of the exemption letter, certificate or completed Inquiry Regarding Licensure School Age or Drop-In Program form. If child care licensure is required, a program may not operate until licensure is approved. It is the responsibility of each applicant to inquire with the Kansas Department of Health and Environment (KDHE), before submitting an application, to determine if licensure is required. Awarded funds are contingent upon determination. All programs identified as required to become licensed will be required to work directly with KDHE. Failure to do so will result in forfeiture of potential a grant award. For more information please visit: http://www.kdheks.gov/bcclr/index.html. The following is a direct link to the Inquiry Regarding Licensure School Age or Drop-In Program form: http://www.kdheks.gov/bcclr/application_packets_and_forms/child_care/ccl_360_inquiry_regar ding_licensure_sap.pdf Appendix E - Equitable Access and Participation. Section 427 of General Education Provisions Act (GEPA) requires every applicant (other than an individual person) to include in its application a description of the steps the applicant proposes to ensure equitable access to, and participation in, its federally assisted program for students, teachers, and other program beneficiaries with special needs. Detailed instructions about how an applicant may comply with these requirements are provided below. Which Equitable Access and Participation regulations apply to this program? Section 427 of the GEPA affects applicants for new grant awards under this program. Section 427 requires each application to include a description of the steps the applicant proposes to take to ensure equitable access to, and participation in, its federally-assisted program for students, teachers and other program beneficiaries with special needs. This provision allows applicants discretion in developing the required description. The statute highlights six types of barriers that can impede equitable access or participation: gender, race, national origin, color, disability or age. Based on local circumstances, the applicant should determine whether these or other barriers might prevent students, teachers, etc., from such access or participation in the project or activity. The description in the application of steps to be taken to overcome these barriers need not be lengthy. The applicant may provide a clear and succinct description of the plan to address those barriers that are applicable to specific circumstances. In addition, the information may be provided in a single narrative, or, if appropriate, may be discussed in connection with related topics in the application. Section 427 is not intended to duplicate the requirements of civil rights statutes, but rather to ensure that, in designing their projects, applicants address equity concerns that may affect the ability of certain potential beneficiaries to fully participate in the project and to achieve to high standards. Consistent with program requirements and its approved application, an applicant may use the funds awarded to it to eliminate barriers it identifies.

2017 Kansas 21 st CCLC RFA 18 What are examples of how an applicant might satisfy the requirement of this provision? The following examples might help illustrate how an applicant may comply with Section 427. An applicant that proposes to carry out a family literacy project or other educational services among parents with limited English proficiency might describe in its application how it intends to distribute a brochure about the proposed project to such potential participants in their native language. An applicant that proposes to develop instructional materials for classroom use might describe how it will make the materials available on audio tape or in Braille for students who are visually impaired. An applicant that proposes to carry out a model science program for secondary students and is concerned that girls may be less likely than boys to enroll in the course, might indicate how it intends to conduct outreach efforts to girls to encourage their enrollment. How should an application be submitted? The deadline for KSDE s receipt of applications is 3:00 p.m. Thursday, March 16, 2017. Applicants must submit one signed original and four copies (individually bound with rubber bands only) of the entire application in one package, as well as an electronic copy. Please use the checklist in this RFA to make sure the application is complete. All applications must be received on or before this date and time. The closing date and procedures for guaranteeing timely submission will be strictly observed. No supplemental or revised information from applicants (including letters of commitment mailed separately) will be accepted. Instructions for submitting paper copies: Send or deliver to: Christine Macy Kansas State Department of Education 900 SW Jackson Street, Suite 620 Topeka, KS 66612-1182 Attn: 2017 21 st CCLC Grant Applications may be delivered between 8:00 a.m. and 3:00 p.m. via mail, courier or by hand before the deadline. Do not send the application to any other address within KSDE. Applicants are strongly encouraged to use a traceable mailing system. Instructions for submitting an electronic copy: WORD format only (No Google or PDF documents) Flash-drives, CDs, etc. are not considered electronic Email to: Christine Macy cmacy@ksde.org Subject Line: 2017 21 st CCLC Grant Electronic applications must be received at KSDE by 3:00 p.m. Please allow adequate time to ensure the email is delivered by the deadline. Questions should be directed to Christine Macy (785-296-3287 or cmacy@ksde.org).

2017 Kansas 21 st CCLC RFA 19 APPLICATION CHECKLIST One original and four copies (individually bound with rubber bands only), as well as an electronic copy, of the application must be received by 3:00 p.m. Thursday, March 16, 2017. Intent to Apply Please use this form in the RFA to notify KSDE of the intention to apply by February 23 rd. Submitting this form does not obligate a potential applicant to apply, but does help KSDE prepare for the review sessions. All required forms need to be submitted in WORD format. A complete application must include the following sections in the order given below: Cover Sheet including the program title, name of applicant(s), district to be served and date Application Checklist Program Summary (Form 2017:1) General Assurances Document including signature of Applicant and/or Co-Applicant (Form 2017:2) Private School Consultation Document (Form 2017:3) Program Narrative (no more than 20 pages, double-spaced in standard type 11 point, one inch margins) Budget Summary full five-year summary and separate summaries for each year of the grant (Form 2017:4) Budget Narrative separate summaries for each year of the grant Appendices (A, B, C, D, E) Any additional information will not be read by the reviewers.

2017 Kansas 21 st CCLC RFA 20 Required Form 2017:1 PROGRAM SUMMARY Title of Proposed Program: Name, USD # and School(s) to be served: Applicant Contact Information: Organization Name: Mailing Address: City: County: Zip Code: Contact Person: Title: Phone: ( ) Email: Applicant is: LEA Community /Faith Based Organization Other ******************************************************************************************** Co-Applicant Contact Information: Organization Name: Mailing Address: City: County: Zip Code: Contact Person: Title: Phone: ( ) Email: Co-Applicant is: LEA Community /Faith Based Organization Other ******************************************************************************************** The Fiscal Agent for this application is: Agency: Contact Name:

2017 Kansas 21 st CCLC RFA 21 Page 2 Program Summary Name of each site that will be part of the 21 st CCLC and the level of students served (elementary, middle, high) 1. Name of the school attended by most of the students served by each 21 st CCLC site in this proposal Total School Enrollment % Free/ Reduced lunch of each school served by each 21 st CCLC site, using 2016-2017 data Proposed average DAILY 21 st CCLC attendance of each site 2. 3. 4. 5. 6. # sites for the entire grant: Average %: Total: Free/reduced percentages for all buildings can be located at the following URL: http://datacentral.ksde.org/report_gen.aspx Please indicate if applying for the following: Competitive Priority I: (Comprehensive Support Schools) Competitive Priority II (Summer Programming) Transportation Allowance (only available for REAP eligible districts)